Podiatrist Ritchard Rosen of Teaneck on cosmetic surgeries for feet and how our feet age

Dr. Ritchard Rosen always wanted to work in medicine, but it wasn't until he was treated for an ingrown nail when he was younger that he realized podiatry was the way to go. "I wanted to help people and give them immediate results," says the 56-year-old Fair Lawn resident.

Rosen earned his undergraduate degree from Boston University, and graduated from the Pennsylvania College of Podiatric Medicine (now the Temple University School of Podiatric Medicine). He is also board certified in foot and ankle surgery and is a fellow of the American College of Foot and Ankle Surgeons and American Professional Wound Care Association. Today, Rosen is the chief of podiatric surgery at Holy Name Medical Center in Teaneck and a doctor at the Northeast Podiatry Group in Englewood.

Here, he shares why you should never let a pedicurist cut the sides of your nails, what makes feet ticklish and what you can do to prevent foot injuries when exercising.

Q. What is the No. 1 reason people come to see you?

For foot deformities, like hammer toes [a joint deformity that makes a toe look permanently bent] and bunions. Pain issues is the second reason.

Q. What happens to our feet as we age?

We lose the fat pad on the bottom of the foot, which causes pain, sometimes calluses, and decreases protection. There's also decreased circulation, and that causes decreased texture in skin – the skin gets shiny and thin, and that leads to breakdown in the skin and ulcerations.

Q. Are women having surgeries to fit into designer shoes?

Yes. There are cosmetic surgeries available — having bones or toes removed in order to wear stylish shoes. Personally, I don't do them or recommend them. Unless there's pain or a deformity, I don't believe there's a place for it.

Q. Are they hurting their feet by wearing heels?

Yes. They hurt their feet and lower back. Heels 2 inches and up can cause stresses on joints in the entire lower extremity.

Q. How do women grow accustomed to wearing high heels?

It's not good for your foot health. But over time, the Achilles tendon shortens and [you] will be more comfortable when wearing heels. The body adapts to it.

Q. What are the worst and best shoes to wear?

The worst are extreme high heels, and the converse — flat shoes — is also true: Worn all the time, they can also cause heel and arch pain and Achilles tendon pain. Recommended is a sneaker with a good arch; for dress shoes, a heel no higher than 2 inches. For a male, a conventional dress lace-up with support.

Q. What ruins feet most?

Top three are ill-fitting shoes, lack of stretching and ignoring foot pain.

Q. What should you do to ensure healthy feet and nails?

Something as simple as stretching them before you get out of bed in the morning. Make as if you're writing the alphabet with each foot [creating the motion of each letter]. For nails, cut them straight across and don't cut into the sides; that causes ingrown nails. You also shouldn't keep nail polish on all year long. Let them [your feet] breathe every few weeks.

Q. How prevalent are bunions? What can you do for bunions and how prevalent are they?

The average practice sees them 10 to 20 percent of the time. They're hereditary, for the most part.